A Blog by Amy Marschall: Everything no one ever told you about surviving graduate school

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Summer vacation is over, at least for me. This week I began my predoctoral internship and my countdown to graduation (in case you were wondering, it’s 361 days). As I get adjusted to my new schedule, I may miss a week or two on my blog. No offense to my devoted readers, but finishing reports on time is priority #1 unless you can find a way to convince APA to count this blog towards my graduation.

Orientation has been a whirlwind of information overload. I know just about everything there is to know about the consortium, and my brain is absolutely fried. Tonight I am relaxing at a hotel near the main site so that I do not have to make the 90 minute drive in the morning.

I apologize for yet another short post, but I am exhausted, and my week isn’t over yet. Just a reminder, I am accepting questions/suggestions for posts. I am also open to guest posts from fellow graduate students if there is an area of expertise you would like to share. Thank you and good night!

The past two weeks my blog posts have focused on things that have been wrong with the world. This week, I get to be more positive because I have a visiter. My partner came to see me, and we were able to extend the visit by a week. Unfortunately this was because neither of us knows when we will be able to see each other again (I am breaking my rule about always having a countdown from my Valentine’s Day post), thanks to some overly-busy schedules in the next few months. As such, I’m cutting this week’s post short so that we can enjoy our time together. Today we are feeding tigers. Yes, you read that correctly. Yes, it’s ok to be jealous.

On another note, because the purpose of this blog is to educate and help people through the process of getting a doctorate, I want to start taking specific questions. In addition to my regular rants about my experience, I would like to take submissions from readers about what specifically you want to know. So put it in the comments or send me a message, and I’ll feature you in one of my posts.

To my friends and neighbors living in the American South right now, stay cool!

So, if you have been paying attention to the news, it has been a rough couple of weeks in the United States. Last week I posted about responses to Robin Williams’s suicide earlier than usual because I consider myself well-versed enough on the issue of mental illness stigma to discuss it competently. This week’s topic has been more difficult for me: The shooting of Mike Brown, an unarmed teenager, in Ferguson, MO. I don’t care what your thoughts are on the robbery that was probably not committed by him and hadn’t been reported to the police at the time of the shooting, I think that any logical person would agree that shooting an unarmed and defenseless teenager is wrong.

Racially-based police brutality is on the rise in America. It’s important to talk about, but it is challenging to find ways to offer support when you are a part of the group that is perpetrating these crimes (in case I am not being clear – white people).

There have been a lot of posts lately in response to the events in Ferguson, and others have already said it much better than I will be able to, so instead of writing a long-winded blog post that will most likely end up focusing on how badly I feel and not on the real issues at hand, I am going to invite anyone reading this to contact me individually so that we can start having these conversations one-on-one. Please leave me a message in the comments if you are interested. We need to get comfortable with being uncomfortable, or nothing is going to change.

Thank you all for your thoughtful responses to my last post. It is times like these that I know I am in the right line of work. Because I tend to obsess, I’ve been reading the massive internet outpouring following Robin Williams’s death, and I decided that my last post does not contain everything I wanted to say on the subject of mental illness and suicide. The result is you get two posts from me this week. Below is a list of comments I often see in response to suicide, including inaccurate perceptions of mental illness and mentalities that are downright dangerous.

If he/she had had more/better friends, he/she would not have died. I addressed this somewhat in my last post, but I will keep saying it until people understand: That is not how depression works. Mental illness does not follow this kind of logic. Look at the metaphor I used in my last post. Would you say that a cancer patient might have pulled through if only they had better social support? Yes, a solid network of friends is important when it comes to overcoming mental illness, but it certainly does not prevent suicide. When someone is in a suicidal mindset, they are not thinking about their loved ones. They are just thinking about the pain that they are in. I am NOT saying that their choice is selfish, but that the level of suffering that comes with clinical depression is so great that you are not capable of thinking of anything else. Have you ever had a kidney stone? Were you thinking about the people who would be inconvenienced by a commitment you were missing? Maybe it crossed your mind, but I would be willing to bet money that your primary concern was how much pain you were in and how to make it stop.

He/she was not brave enough to keep fighting. Suicide has nothing to do with bravery. Again, mental illness does not follow this kind of logic. Suggesting that people with suicidal thoughts are cowardly is counter-productive. That kind of negativity only serves to further beat down individuals who are already struggling. This same argument applies to calling victims of suicide selfish.

People with depression just need to be stronger and get over it. When I am feeling upset, I really try to avoid saying that I feel “depressed” because depression isn’t equal to sadness. Depression is a pervasive state of being that transcends more fleeting moods. There is a reason why a diagnosis of clinical depression requires that symptoms be persistent for a minimum of two weeks: Because depression is more than just feeling low or sad for a short while. Think about it. If it were so easy to “snap out of it,” why would anyone kill themselves?

But he/she didn’t seem depressed. This plays into the myth that depression has to look a certain way. Most of us have a picture in our minds of what we think depression looks like, and while there most likely exist cases that fit this image, no two cases are identical. Everyone copes differently, and there is no way to know for certain what someone else is thinking and feeling. Some people prefer not to show their emotions and may seem stoic or even sad when they feel fine. Others project a similar demeanor in response to the pain they are in. Some use humor to cover how they are feeling. Others joke constantly because they feel happy and want to share it. It is impossible to paint a picture of depression because no one picture could accurately encompass every experience.

He/she just wanted attention. Suicide is not something to trivialize, and that is what this statement does. I hear this a lot in response to people who use means with lower lethality for a suicide attempt. This phenomena stems from the stigma I have been talking about. When we teach people that they are weak or lesser than if they seek help for mental illness, it becomes difficult to say “I need help” or “I am depressed/thinking about hurting myself.” When you feel you can’t express your pain in a healthy or productive way, it comes out by other means. Are the individuals in these cases seeking attention? Technically yes, in that they desperately want and need help that they do not know how to seek. There are much easier ways to get attention. That is not what suicide is about, and it is insensitive and stigmatizing to claim otherwise.

“Genie, you’re free.” This quote has been circulating Twitter these past few days, and it has been bothering me. I need to explain why this quote makes me so angry. Sure, it’s poetic and will probably get you some attention for posting it. But let’s take a minute to really think about what this statement implies. Essentially this quote is stating that, because he is dead, Robin Williams is now cured of his mental illness. After a celebrity dies by suicide, the suicide rate goes up for a short while. That is something that we are already at risk for right now. The implication that death is freeing is a dangerous one. Imagine you have been struggling with suicidality. You hear that Robin Williams, a world-famous actor, has killed himself. You then see a huge outpouring of emotion from his fans saying that he is now “free.” Suddenly that tweet sounds like an argument in favor of ending your life. I stated in my last blog post that asking someone if they have had suicidal thoughts will not trigger this way of thinking, and that is true. However, saying to a friend, “I’m worried about you. Have you had thoughts of wanting to hurt yourself?” is hugely different from asserting that suicide is somehow a cure for mental illness, and when it comes down to it, that is what this quote is saying. Please stop romanticizing this tragedy. If you shared this tweet, please take it down. It is dangerous and needs to stop.

Education is the only way we can fight against the stigma surrounding mental illness. Don’t wait for someone you know to be effective. Spread this information now and maybe fewer people will have to suffer this way.

I’m taking a break from my typical format to talk about the passing of a phenomenal actor and a huge part of my childhood. Normally I am relatively unaffected by celebrities’ deaths, but this one hit me in a way I was not expecting. Robin Williams’s history of mental illness is not news to the public, something he had been struggling with for a long time. No one knows for certain what was going through his mind during his last hours.

The reports we the public are being given are suggesting that Mr. Williams took his own life. This makes his death even more upsetting, knowing that he found himself in such a hopeless place that he felt he had no other options. This brings up a much larger issue surrounding how mental illness is addressed in this country. There exists a culture in the United States where it is difficult to seek help for depression. We tend to promote the mentality that depression is an emotion rather than the illness that it is, that a “strong person” can “snap out of it” if they really want to. This is not the case. A comparison that I like to give my clients is to replace mental illness with cancer. No one would ask a cancer patient, “Have you ever tried not having cancer?”

Luckily, unlike cancer, most mental illness is responsive to appropriate treatment. However, even those who are fortunate enough to have the resources available to them for treatment are faced with a huge stigma. Inaccurate media portrayals of mental illness and an overall dismissive social attitude has potential clients asking themselves, “What kind of person goes to therapy? Am I that kind of person?” Or more specifically, “Am I crazy?” (There is a massive controversy within the field of psychology surrounding the term crazy. I am trying to stay focused and will not address this in depth right now.)

Fear of judgement and stigma can prevent people from reaching out. If you have any suspicion that someone close to you might be suffering, do not wait for them to ask for help. In several of my graduate classes we discussed a fear of “planting the seed” by asking clients if they are having thoughts of suicide. Research has shown that, if someone has not considered suicide, they will not suddenly have ideations if someone asks. The power of suggestion is just not that strong. But if they are having these thoughts, there is a good chance that they will open up about it if asked. The APA provides this great article for talking to someone about an emotional crisis.

However, you do not have to wait until a crisis emerges to fight the stigma surrounding mental illness. Make it clear that you are willing to listen if something comes up. Correct people when they make false and stigmatizing statements about mental illness. This comic perfectly illustrates the ridiculous nature of those kinds of claims. Recovery is possible, but not if we beat down everyone who seeks help. Be the change, and maybe others will not have to die.

Finally, if you are having thoughts of suicide, please seek help. The number for the National Suicide Hotline is 1-800-273-8255, and they are available 24/7 and can provide you with support and resources in your area. Program it into your speed dial so that you don’t even have to think about it before making the call. You might not see it right now, but it will get better.

My condolences to Mr. Williams’s family and loved ones during this tragic time.

“Our job is improving the quality of life, not just delaying death.” ~ Robin Williams in Patch Adams

I moved for my internship almost three months before my placement started, and initially I had planned to secure a summer job. The market in small-town Arkansas had other plans. I have been getting involved in the community and volunteering, which is incredibly rewarding on a personal level, but unfortunately my landlady doesn’t accept a sense of personal fulfillment as payment for rent. So when I saw a commercial offering $300 for participants in a medical trial, I signed on and got an appointment for a qualifying physical.

The thing no one tells you about that physical is that they plan on only half of the physicals showing up, so they end up with more people than they will accomodate. Fortunately I overestimated my tendency to get lost any time I go anywhere, and I arrived an hour early. Chatting with the people in line ahead of me (because apparently an hour early was still cutting it close), I learned this is pretty typical, especially with studies that pay several thousand dollars.

I also learned that we had to sit outside in the sun on sharp rocks until they were ready to take us. This organization does nothing other than conduct these studies, and their method is to encourage people to show up hours before the scheduled time, and yet they don’t allow participants inside until the scheduled time. I would think they would at least set up something to provide shade (especially since sunburn was an automatic rule-out for this particular study), and possibly some chairs. But they know we need the money badly enough to keep coming back no matter how we are treated, so they don’t seem in a hurry to change their system.

Anyway, I passed the physical and was accepted into the actual study. I was told to arrive between four and five AM for the actual study, because germs never sleep so apparently neither do I. I arrived at exactly 4:00 just in case there was another line. A group of us stood outside for forty-five minutes waiting to be let in. As it turns out, we could be disqualified and kicked out of the study without pay if we were late, but the people in charge aren’t held to the same standards. There were employees inside during the entire time we were waiting, people who saw us but avoided eye contact, who answered the phone when we finally called to ask what was going on, pretended to have a bad connection, and hung up. All the while we stood outside with the mosquitos (the trial involved the use of ointment, so we weren’t allowed to use bug spray). When we were finally let in, we were told “There’s been a scheduling issue.” No further explanation, no apology.

Then we were each assigned a number and told to answer to that number for the duration of the study (I asked and was told that we are easier to keep track of that way). We then proceeded to eat, sleep, and be medicated on a rotating schedule that didn’t allow for anything more than a series of 2 hour naps. We could have had longer stretches to sleep, but the study “required” that we be fed on a different schedule than the application of ointment, as well as the monitoring of our response after the cream had been removed, so we had to keep waking up. I asked why the schedule wasn’t more logical, and an employee said that the people running the study frankly don’t see the participants as human beings with biological needs but as blips of data on a computer screen. I had been awake for about twenty hours on three hours of sleep, so I responded that we’re all just blips of data on that great cosmic computer screen we call life.

As the study went on, I bonded with my fellow participants. We laughed together and over-shared personal stories. At some point we managed to get some sleep. For some reason we spent almost a solid 24 hours watching a Law & Order: SVU marathon. It was a nice excuse to mess around on my laptop for almost 2 full days and still feel productive – I was being paid for my time, after all.

Overall, if you can get past the dehumanization and can function with continuous interruptions to your sleep, it is an easy way to make money. The recliners they made us sleep in, all lined up with no privacy, were surprisingly comfortable. I think I will stick to studies lasting 2 days or less for the sake of my mental health. I did make some notes for next time, which I will share in case you are considering a similar venue for easy money. And it is seriously easy money, Including my first-time bonus, I made more than a month’s rent, and all I had to do was put ointment on my arms and watch TV for two days.

Bring a pillow and blanket. They ran out of blankets, and some people were left without. Besides, the few they did have were gross.

Bring socks. You do not want to walk around barefoot, and wearing sandals all the time gets uncomfortable.

Get lots of sleep the night before. You never know what conditions you will be trying to sleep in, so assume you’ll be awake for most of the study.

Make friends. The other participants are just as uncomfortable as you are, and being uncomfortable in solidarity is kind of fun.

Wear sweatpants and a comfortable t-shirt. Seriously, this isn’t a pick-up scene. Comfort is your only priority.

Shower as often as you can. For this particular study we weren’t allowed to bathe, and in these close quarters everyone around you will thank you to minimize your BO.

Bring a power strip. I guarantee there will be more iPhones, laptops, and tablets than there are outlets. Everyone will thank you.

Bring ear plugs and a sleep mask. Trust me.

I do think the pharmaceutical testing industry needs to seriously reconsider how it treats its participants. Without us, you wouldn’t be able to push medications through the FDA for general use. We would appreciate some consideration.

When I underwent Phase II for the second time, I was completely emotionally wiped out. I have talked before about my strategy of applying to every site that had an opening. Faced with the prospect of a third round of applications, I was burning out fast. Then something amazing happened – sites were offering me more interviews than I had time to schedule them. (I do not care how stressed out you are, this is the best possible “problem” you can have while applying for internship. Complaints about finding time for all of your interviews will be met with hostility and being punched in the face, and no one will feel sorry for you.) My point is, I went all in on this phase. I was like someone running away from a serial killer who sees a ravine a head. You take the last bit of energy you have and throw yourself forward, knowing you will either fall to your death or be safe from harm on the other side. (In this scenario the serial killer is not very good at jumping.) I made comments to friends and family after my second Match Day that, if I didn’t get an internship in Phase II, I did not think I had it in me to apply a third time. It was this or dropping out of my program. And now that I am on the verge of starting my internship, I honestly do not know what I would have done had I been put in the position of making good on that promise.

I essentially coasted into the Phase II match on fumes with no energy left for anything else. Then, after the celebration ended, I realized that the journey was far from over. I had to move and figure out how to adjust to a new town. The transition takes energy – save some. Maybe you will be fortunate enough to not have to move for your internship. For a lot of people this is the most feasible option for completing their degree, but if you have the flexibility to relocate, I do recommend considering trying a new place. Having spent my entire life in Minnesota, four years of schooling in Connecticut pulled me out of my shell in a way that staying put never would. For my internship I headed South and am excited for another unique experience. However, moving is stressful.

When I was researching my move, the easiest and most affordable option was to ship my belongings and drive myself and my cats. Side note, cats do NOT like long car rides. I also suggest, if finances allow, taking a trip to apartment hunt prior to the move. Knowing exactly where you are going, and being able to see a place in person prior to signing a lease, is a huge stress relief.

As far as engaging in your new community, it is hard to make friends in adulthood! As someone who has been a full-time student since I was five, I have never had to actually go outside and meet new people. Social situations and friends have always been provided for me by my school. For the first week that I was in Arkansas, I barely left my apartment. Where was I supposed to go? Enter Facebook, of all things. I found a couple of local groups focused on some of my interests, met a couple of people, was introduced to more people, and now I’m not sure how I will work my internship into my busy social schedule. 🙂

So, thank you for bearing with me as I rambled through my expertise on the internship process. This concludes my series for now, unless someone points out something that I missed. Good luck!

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About Amy Marschall

Amy is a 5th year doctoral candidate in Clinical Psychology. She defended her dissertation in May of 2013 and recently matched for internship. Her interests are diverse, and her primary specializations include treatment for survivors of sexual violence and therapy with college students. In her spare time, Amy enjoys baking, hiking, making jewelry, and spending time with her two cats. She will start her internship on September 1, 2014.

She updates her blog every Thursday.

This is the personal blog of Amy Marschall. It contains only her own views, thoughts, and opinions. It is not endorsed by any company or organization with which she is affiliated, nor does it constitute the official communication of any organization.